What If a Flu Breaks Out When CDC Can’t Track It

By David Satcher -
Oct 13, 2013

As director of the U.S. Centers for Disease Control and Prevention during the last government shutdown, in 1995-1996, I can attest to the very real potential for unnecessary pain, suffering and death when the work of public-health officials is curtailed.

As a consequence of the current shutdown, the CDC has been required to furlough two-thirds of its staff, leaving only 4,000 people to conduct vital public-health responsibilities. This translates into reduced protection for Americans. Here are just a few examples:

-- Surveillance for detecting and responding to infectious diseases is weakened: Nine of the 10 Global Disease Detection Centers have significantly reduced monitoring for diseases such as Ebola and new pathogens such as Middle East respiratory syndrome and H7N9, which could threaten the U.S.

-- CDC doesn’t have the personnel to monitor, track and provide guidance about seasonal flu activity, even as the season is beginning. The virus claims thousands of lives in the U.S. every year, and that’s when the CDC is fully staffed.

-- Although state public-health investigators can detect disease outbreaks, the CDC’s ability to conduct cross-state collaboration and lab work for linking these outbreaks is severely diminished.

-- The CDC isn’t able to conduct routine inspections of high-security labs to ensure that they are taking appropriate precautions when handling deadly agents such as anthrax, monkeypox and Ebola.

-- Staffing at the Emergency Operation Center is minimal. In the event of a natural or man-made disaster, the CDC will have difficulty in responding quickly and efficiently to any public-health challenge.

In 1996, it took CDC on average 167 days to identify an outbreak. Today, thanks to advances in technology, it takes about 20 days. The shutdown, however, could greatly reduce the speed of disease detection and needlessly cost lives.

The shutdown’s effects on public health could have terrible economic costs, too. A little more than 10 years ago, severe acute respiratory syndrome was detected relatively quickly, within a few months of the first outbreak in Asia in November 2002. Still, more than 800 people in 30 countries died, and the world economy suffered a $30 billion to $40 billion blow.

Importantly, the longer a shutdown lasts, the more difficult it is to catch up. That’s because it takes any agency time to get back up to speed when the government fully reopens. That means days can turn into weeks, and weeks into months.

Shutdowns also take a toll on morale: It’s frustrating for any organization to try to carry out its vital mission with inadequate resources, and dedicated staff members are discouraged when they think their roles have been devalued.

The most critical danger, however, could be the blind spots in detection that inevitably develop as a result of understaffing. We may be lucky this time and avoid any severe outbreaks. But surely we can agree that it is irresponsible to base our disease detection and response strategy on luck.

I urge our leaders to come up with a solution that ensures that the men and women of the CDC -- and people throughout the government and those who work with the government in the private sector -- are back on the job protecting our nation’s health, security and economy. The longer the shutdown persists, the more we are all at risk.

(David Satcher, a physician, is director of Morehouse School of Medicine’s Satcher Health Leadership Institute. He was director of the Centers for Disease Control and Prevention from 1993 to 1998 and U.S. surgeon general from 1998 to 2002. He serves on the board of directors of the CDC Foundation.)

To contact the writer of this article: David Satcher at dsatcher@msm.edu.